Miss. Medicaid expansion effort hobbled in House

JACKSON — Mississippi House Republicans are again trying to thwart long-shot efforts by Democrats to expand Medicaid, with each side accusing the other of endangering coverage for low-income people who are already on the program.

The House Rules Committee on Thursday blocked a Medicaid bill that had already been passed by the Senate. Senate Bill 2207 didn’t include expansion but it did have sections that Democrats could try to amend to add it.

Under the federal health overhaul that President Barack Obama signed into law in 2010, states have the option of expanding Medicaid to cover people making up to 138 percent of the federal poverty level, or about $15,000. Mississippi’s cutoff is now about $5,500.

Republicans hold a majority in both the state House and the Senate. Republican leaders, including Gov. Phil Bryant, say the state can’t afford Medicaid expansion, even with the federal government covering most of the cost. The federal government would pay 100 percent of medical expenses for the newly qualified enrollees from 2014 to 2017, then the federal share would be reduced to 90 percent by 2020, with each state paying the balance. Six Republican governors have proposed expanding Medicaid in their states to cover more low-income residents, citing the financial realities of their states’ medical costs.

Medicaid is the federal-state health insurance program for the needy. Mississippi’s Medicaid comes up for review every few years, and lawmakers must vote to keep the program in business. This is one of those years.

The House and Senate each filed a bill this session to keep Medicaid alive beyond June 30, the final day of the current state budget year.

The House bill did not include sections that could be amended to add Medicaid expansion. When that bill came up for debate Jan. 31, House Democrats were joined by a few Republicans in killing the bill. Democratic leaders said they hoped that action would lead to a later debate on the Senate bill, which could’ve been amended to include expansion.

Friday is the deadline for the House to try to revive its own bill, and House Speaker Philip Gunn said there will be a GOP-led effort to do so.

Gunn said there are not enough votes in the House to pass the Senate bill. Republicans hold 65 seats and Democrats hold 55.

“Because of this, the House was faced with what would have been a long and divisive debate on the issue of expanding Medicaid under Obamacare, which would have served no purpose and would have ended with the bill being defeated,” Gunn said in a statement Thursday.

Gunn said expanding Medicaid “is not an option.”

“House Bill 560 is carefully drafted to forbid Obamacare expansion; so, we find it prudent to discard the Senate bill and use our own instead,” Gunn said. “If HB 560 passes, the Medicaid program will continue as it now exists. If it fails, Medicaid’s continued existence will be in doubt, and many of Mississippi’s children, patients in nursing homes and some of our most vulnerable citizens will be at risk.”

House Democratic Leader Bobby Moak, of Bogue Chitto, said expanding Medicaid would help low-income residents who are currently uninsured and would boost the state economy by supporting medical jobs.

“We are ready to kill every bill that comes before us that does not allow for a full vetting of the crucial question of Medicaid expansion,” Moak said in a statement Thursday. “Any attempt by Republicans to suggest that they don’t have options to revive a Medicaid bill is nonsense. They have the Governor’s Mansion, the Senate and the House. If a Medicaid bill doesn’t pass in the next month it’s because Republicans are more interested in playing politics than doing their jobs.”

Bryant said Gunn showed strong leadership by killing the Senate bill.

“The action by the House leadership today will prevent political posturing at the expense of vulnerable citizens,” Bryant said.

Republicans say if no bill to reauthorize Medicaid passes, Bryant could run the program by executive order. Democrats dispute that.

Mississippi has roughly 3 million residents, and the Division of Medicaid says 641,378 were enrolled in the program in December.

A study conducted by the Urban Institute for the nonpartisan Kaiser Commission on Medicaid and the Uninsured estimates about 288,000 newly eligible people could be expected to enroll in Medicaid if Mississippi does an expansion. The study says another 57,000 who are eligible for Medicaid under current standards could be expected to sign up.